脊柱侧凸为首发症状的Chiari畸形临床研究

目的 研究以脊柱侧凸为首发症状的Chiari畸形的临床特征和治疗策略.方法 收集南京鼓楼陕院住院治疗的Chiari畸形患者60例,35例以脊柱侧凸为首发症状;25例末合并脊柱侧凸作为对照组,病例对照研究.结果 35例Chiari畸形合并脊柱侧凸患者,年龄3～33岁(平均13.75岁),97%合并脊髓空洞,不具有典型的Chiari畸形的临床症状和体征,以腹壁反射异常多见.两组之间手术方式和手术并发症无统计学意义.结论 Chiari畸形以脊柱侧凸为首发症状,多合并脊髓空洞,发病年龄轻,其临床症状和神经损害体征不明显,治疗策略上主张早期进行枕颈部枕骨大孔区减压和硬脑膜重建成形手术.

Study of Chiari malformation associated with scoliosis as the first symptom

Objective To study the clinical manifestation and intervention strategy for Chiari malformation associated with seoliosis as the first symptom.Methods 60 patients with Chiari malformation were included in this control study.Among which 35 patients were Confirmed to be Chiari malformation associmed with scoliosis as the first symptom.These 35 patients were included in test group and the other 25 patients were included in control group.Results 35 patients in test group were younger(3～33 yrs old,average 13.75 yrs).The abnormal neurological manifestation of typical Chiari malfi,rmation was slight in test group.Most of these patients in test group had syringomyelia(97%)and ahnormal upper abdominal reflex.There was no diflhrence between the two groups in surgical intervention and postoperative complication.Conclusions In order to decrease the risk of neurological complication,foramen magnum decompression (include C.posterior arch)is necessary before instrumentation and correction of scoliosis in Chiari malformation patients with syringomyelia and scoliosis as the first symptom.